Wednesday Clinic

Today is Wednesday, and I had another clinical follow-up after my kidney transplant. We went in this morning around 9:00 to have blood and urine taken. Then it was time for some quick breakfast and a long wait in the waiting area. By about 10:30, they called us back to see the doctor.

He said that everything is looking great. He was ready to not see me again until next week, but I have a bone density test scheduled for Thursday (in Fort Worth) and we are booked in the hotel until Friday, so we said that we will just go ahead and come in to the clinic on Friday, as well.

Next week, however, we will only be driving to Fort Worth on Monday and Friday. This means that we will not be staying in a hotel, and that we will get to spend some time at home. I am sure that the TiVo will appreciate this, as it is probably getting full. Also, it will be nice to sleep at home in my own bed and sit on my couch to watch TV (instead of being in the hotel all day).

The doctor said that I am healthy enough to go ahead and be in public. So, I think that Jenny and I will be attending church this Sunday. We might have to sit over in the big empty section of the Worship Center, but that will be okay. At least we will be able to get back to church and start feeling like normal people again. I have not decided if we are going to go to our Adult Bible Fellowship class (Sunday School) on Sunday or not. It kind of depends on how I feel after the service.

Let's see ... what else is interesting? One of my staples pulled out on one side, so the doctor removed it and gave me a couple of "Steri-Strips" to go in its place. For those of you who do not know, Steri-Strips are little pieces of tape that they glue to you after the staples are removed. They help keep the surgical wound closed after the staples have been removed ... and they normally just fall off on their own. The doctor said that the rest of the staples should be able to be removed in about two weeks. After that, they will transfer my care to the Dallas Transplant Institute, so that we do not have to drive so far for our appointments.

The doctor was also of the opinion that, as long as things continue as they are going, that I should be able to return to work around February 12. I will have to confirm this with my new doctor that I am assigned to in Dallas, but I do not see that as being a problem. As long as I am feeling well, I would like to get back to work as soon as I can. It will help me feel like I have gotten back to normal, and that is what the kidney transplant is all about.

Here are the important lab numbers from today's clinic:

• Potassium was 4.3 (range is 3.6 - 5.0)
• Creatinine is 1.0 (range is 0.7 - 1.2)
• BUN is 9 (range is 9 - 20)
• Glucose is 83 (range is 75 - 110)
• Hemoglobin is 11.7 (range is 13.5 - 18.0)
  The hemoglobin is a little low, still, but better than it was on Monday.

As far as I know, my medication levels are all still OK. The doctor did not change anything today, and I have not gotten a call from the clinic telling me to change anything. The change that the doctor made in my Cellcept® dosage on Monday has seemed to help my stomach quite a bit. I have enjoyed that much more than before.

For those of you that are interested, here is a list of medications I am currently taking:

• Cellcept® - 1500mg / day: prevents rejection
• Prograf® - 8mg / day: prevents rejection
• Prednisone - 20mg / day: prevents rejection
• Bactrim® (a generic version) - 400mg/80mg / day: treats/prevents bacterial infections
• Protonix® - 40mg / day: treats/prevents stomach ulcer/heartburn
• Valcyte® - 900mg / day: treats/prevents viral infections
• Mycelex® (a generic version) - 40mg / day: treats/prevents fungal infections
• Restoril® (a generic version) - 15mg / day: treats insomnia

Those are the "new" post-transplant medications that I am taking. In addition, I also take:

• Atenolol - 25mg / day: a beta blocker to lower blood pressure and heart rate
• Zyrtec® - 10mg / day: for seasonal allergies
• Lipitor® - 10mg / day: lowers cholesterol
• Cerefolin® - PAL/M5 (two per day): B12/LM-Folate/B6/B2 vitamins to lower homocystine levels
• Folic Acid - 800mcg / day: to lower homocystine levels

So, all of that is supposed to keep me healthy. I imagine that it will, as the doctors have been doing this for much longer than I have. They eventually hope to get me off of the Bactrim®, the Valcyte®, and the Mycelex®. The doctor said I should probably be on those for a year at the most. They will also lower the Prednisone dosage (maybe as low as 10mg per day), which I hope will help with the insomnia (meaning I could get off of that drug, too).

The doctor pointed out something I found interesting. For the first time in my life, being a Caucasian male has some benefits. I mean, it would be great if I was running for political office, but it seems it is also good for transplant recipients. Us white boys seems to have less rejection than the rest of the population, so we don't get quite as many immunosuppressants on our first donated organ. That is good for me, as it makes me able to be back to normal sooner.

The only other thing we had been asking the doctor was about fathering children. The kidney transplant education packet that I received said that men should not father children for one year after receiving the new organ. Jenny and I had wondered why this was. The doctor told us that there was a 3% - 5% greater chance of there being genetic abnormalities as a result of the high levels of medication in my system. Just something interesting I thought I would pass along. Granted, I have a much better chance (50%) of passing on Polycystic Kidney Disease to any child I father ... so who knows?

That's it for today. Please continue to pray for my recovery. And, keep praying for the donor's family. Thank you for reading!

Monday Clinic Report

Good Monday everyone. Today was my second post-transplant clinic appointment. They drew blood in the morning (they found a vein on the second stick). They only needed three vials today instead of four. They also did a urinalysis. I am still not used to those, after going so long without having to do that.

The doctor looked me over and said that everything was looking good. Here are some of the lab numbers:

• Potassium was 4.0 (range is 3.6 - 5.0)
• Creatinine is 1.0 (range is 0.7 - 1.2)
• BUN is 14 (range is 9 - 20)
• Glucose is 80 (range is 75 - 110)
• Hemoglobin is 10.8 (range is 13.5 - 18.0)
  The hemoglobin is a little low, still, but that is normal for a new kidney.

The doctor looked at my incision. There is a little bit of pinkness around it, and it is still a little swollen, but he said not to worry. There was one staple that he said might be a concern, but no problems today. He was so encouraged that he offered to let us skip our Friday appointment.

I told him that we would go ahead and come, since we have already gotten the hotel room for the entire week. Besides, I have to go on Thursday to have a bone density scan done (while I am here). So, we will have clinic again Wednesday and Friday of this week. But, it sounds like he might reduce the number of appointments that we have next week.

We will continue to have clinic in Fort Worth until the staples are taken out. After that, they will transfer us to Dallas Transplant Institute (DTI) in downtown Dallas. That will cut our drive in half, so we will not be needing to get a hotel (and we get to stay home).

The doctor said that the prednisone was the most likely cause of my sleeplessness. He said that your body produces a hormone (called cortisone) when it is time to wake up, and that prednisone is basically an artificial cortisone. So, it makes you want to stay awake all the time. He said that the sleeping pills should not be a problem and that if I need them for more than a few weeks, he would prescribe a longer-term (less addictive) sleeping pill. He also said to get more exercise (which was already a goal anyway). That should help out with sleeplessness later, too.

I received a comment asking about my immunosuppressant drug levels. My Prograf® levels at my Monday lab were 11.6. They did not make any changes to my dosage (4mg twice a day). It takes longer to get a result on your Prograf® levels than it does for the rest of the blood. If they ever need to change, then they said they will call between 2pm and 4pm. I should know this afternoon if I need to make any changes.

The doctor did make one medication change. I was taking 1000mg of Cellcept® twice a day. I was also having a lot of stomach irritation after eating. The doctor said that the Cellcept® was the most likely cause. Cellcept® is one of the immunosuppressant medications that I am on. He said it might help if I change to taking 500mg three times a day (for a total of 1500mg instead of 2000mg). I am going to start that tomorrow. I'll have to wait and see if it helps.

Well, I think that is all of the updates I have for today. Thank you for coming by. Please continue to pray that my body will not reject the kidney. Also please pray for the donor's family, as they are still grieving a loss. Thanks for reading!

Clinic Week II

We have clinic appointments on Monday, Wednesday, and Friday in Fort Worth this week. We have decided to come to Fort Worth and stay in a hotel this week. We checked in this afternoon, and our room has a microwave and refrigerator, so we can keep water cold and make some popcorn.

I am looking forward to my second lab appointment, so that I can start collecting lab reports to compare and see how I am faring. The numbers were all just on a chart in the hospital, so I did not really get to take those home.

I updated the forms that the hospital gave me. I had a 2-page form of medication reminders. I had a single page for health record information. I got on the computer, and created a one-page document that has my medication list/reminders and has the blood pressure/weight/temperature/etc for the health record. That way, the doctors and I can look in one place and see all the information. I am not a big fan of flipping through several pages just to find some information.

So, nothing new today. I am still feeling well (though a little short on sleep). I think I am going to take some sleeping pills this week and see if that helps. I also plan to ask the doctor about that tomorrow. But, I am feeling healthy, and there have not been any problems. I have not needed any pain medication in several days, and about the only pain left is just around the incision. There is still some swelling (fluid retention) around my waist and in my face and legs. But, all that should go away in time.

Tomorrow, I hope to have much more information. Enjoy!

Thursday, January 18 - Update

Welcome to my blog, following my chronicles as a Polycystic Kidney Disease sufferer and a recent kidney transplant patient. My story has several chapters, and the one I am currently on is titled: "Post Transplant: or How I Learned to Stop Worrying and Love the Kidney."

We went to Fort Worth to receive our transplant, because that is where the cadaver organ was sent. It is a little over 50 miles away from our home, so that makes for a long drive with follow-up appointments. This would not normally be a problem, except that we live in Texas. For those of you with access to the Weather Channel, you will know that ice and snow have been blowing through the area since late last week. Now, of course, that is "Dallas" snow and ice. So, for those of you up north, what it means is that it is cold and rained, and then the road froze. This scares most drivers to death, making the roads much more hazardous than they would have been if I lived somewhere that actually knew how to deal with snow and had drivers that learned to drive in it (more than once or twice a year).

I say all that to say, we decided to stay in Fort Worth for a while. We have follow-up appointments at the hospital until the staples come out of my incision (I think). This is normally about two or three weeks worth of appointments, three times a week. They draw blood at each appointment and verify that all of my anti-rejection medications are being given in the right amounts. If not, they can dynamically adjust my medications on a regular basis to give me the best chance to keep my kidney.

So, it's Thursday, and I am blogging from a hotel. The Fort Worth Stock Show is in town, so we had to find a room with no cows in it. It's not bad, but the mooing might get to be a little much at night, we will have to wait and see. We will stay the night and go to our appointment in the morning and then head back home. But, we will return next week for another full week of hotel stays and mooing (or not, I think the Rodeo finishes this weekend).

I don't know how long we will have to come down here, but it should not be a problem. The insurance company will "help out" a little with the cost, so that should be nice. And, I should get my paperwork next week (or sometime) to fill out my information for Short Term Disability. This way, I can still get a little money while I am not working. I am hoping to be released to do part time work from home eventually, so that I can start getting back in to everything.

Well, thanks for reading. I will try and post again tomorrow, but probably not until we get home. Maybe I will have some good information, lab report wise, since I know you all were starting to miss those from my old dialysis reports.

See you tomorrow!